REHACARE 2018: Smart aids for more participation

At the end of 2017, there were around 7.8 million people with severe disabilities in Germany. A wide range of digital aids facilitates their everyday life. How these aids can be used intuitively needs to be considered during the early development of the products. Examples for marketable products and innovative trends are on display at the international specialist trade fair REHACARE from September 26 to 29 in Düsseldorf.

Almost every tenth citizen in Germany (9.4 percent) is severely disabled. At the end of 2017, around 7.8 million people with severe disabilities were living in Germany, according to Destatis, the Federal Statistical Office. 51 percent of these were men and 49 percent were women. The causes are mainly due to diseases and the ageing population.

Exoskeletons, which enable paraplegics to walk, walking sticks equipped with tracking systems, apps that exercise the memory or steer and control orthotics – a variety of intelligent aids support people with disabilities in their personal and professional everyday life.

The Human Motion & Control department at Parker Hannifin introduces their new therapy exoskeleton INDEGO (Hall 4, booth B48). This device completes the INDEGO exoskeleton offer by covering the entire therapy chain from inpatient to outpatient treatment, including home care.

The exoskeleton weighs less than 15 kilograms in total and was developed for people with limited mobility due to spinal cord injuries or other neurological diagnoses. Thanks to special software, therapists can offer a specific walking therapy based on the principles of motor learning. As the exoskeleton can be handled quickly and efficiently, potential users benefit from an intensive training that leads to an improved gait, increased walking speed and endurance.

The new orthosis system by Ottobock provides new freedom of movement and with it, more independence (Hall 6, booth A37). The C-Brace® is the only paralysis orthosis worldwide that can control both the stance and the swing phases of walking. Thus, SSCO stands for Stance and Swing Phase Control Orthosis. Sensors in the joint recognise which phase of the walking cycle the user is currently in, the microprocessor regulates the hydraulics resistance accordingly.

This enables people whose knee extending muscles are completely or partially paralysed – for example as a result of polio – to bend their knee under load and thus master inclines. This enables them to walk down stairs and on uneven terrain. The new C-Brace® is much smaller and lighter than its forerunner and allows an even more dynamic and sensitive motion sequence. In addition, the orthosis system can be worn discreetly under clothing. A further benefit: C-Brace® can be used simply via a smart phone app. This allows users to select special modes, for example for cycling.

Not every user can cope with the touch screens on smart phones, tablets or laptops. Among others, people with tremors struggle as the hand’s involuntary movements make it impossible to use the surface. The innovative aid AMAneo by CSS Micro Systems was developed specifically for this target group (Hall 5, booth C10). The supporting mouse adapter can be connected via the USB interface. Thanks to an intelligent algorithm, it uses the tremors to calculate the desired action, enabling potential users to cope with conventional devices.

Eye control and tracking systems

“Eye control is becoming increasingly more significant in digital aids,” explains Ina Siemer, Marketing Manager at Humanelektronik GmbH in Worms. “This type of control is used in supported communication, in computer glasses or wheelchairs, among others.”

The company Humanelektronik (Hall 5, booth C07) uses this technology in their communication aid SeeTech®PRO. Users communicate by using their eyes to combine letters, words or symbols to form a text, which is then emitted by a loudspeaker using a computer voice. When combined with environmental control, the system is also able to open and close doors and windows, or switch lights on and off.

The SeeTech®Wheelchair integrates eye control to navigate the wheelchair. The control module consists of a camera as well as light sources and emits infrared rays. The built-in camera captures the light that is reflected by the eyes, thus enabling the system to recognize what point of the screen the user is looking at. “Research is currently working on completely automating wheelchair controls. With the aid of a camera that can capture the surroundings, we aim to make wheelchairs safer and enable users the greatest possible degree of independence,” says the Marketing Manager.

The Smartstick, developed by Ossenberg (Hall 4, booth A40), cibX and Deutsche Telekom, is a light, height-adjustable walking aid that impresses with integrated electronics. Users of this walking aid can be located anywhere in Germany and Europe via the built-in GMS modem, GPS antenna and SIM card. “The product is not only made of light and durable materials such as carbon, the tracking system and integrated emergency call system also offers people who have difficulties orienting themselves, as is the case in the early stages of dementia, the opportunity to combine mobility with a high degree of security,” says Carsten Diekmann, the company’s CEO.

Future technology mind control

Brain-computer-interfaces can measure brain signals and thus read thoughts, so to speak. The CYBATHLON, organized by the Swiss Federal Institute of Technology in Zürich (Eidgenössische Technische Hochschule Zürich), aims to drive research in this area so that people with severe disabilities can control aids such as computers, robotic arms or wheelchairs.

Participants in the CYBATHLON discipline “Virtual mind-controlled race” have severely restricted or no volitional control of movement from at least collar height due to, for example, spinal cord injuries, strokes or neurological diseases. In order to tap the potential of brain-computer-interfaces for these people, most of the participating teams use electroencephalography (EEG) to recognise brain signals. However, other methods such as near-infrared spectroscopy (NIRS) are also allowed.

REHACARE visitors can try out this technology for themselves and experience how it feels to control a computer game via headset. Here, the avatars are moved using mind control (Hall 3, booth F04).

Uniform standards often lacking

When digital aids are being developed, functionality needs to take centre stage. “It is important to adapt innovations to the user’s capabilities and avoid them having to learn new ones,” emphasizes Christoph Jo. Müller, President of the Federal Association for Electronic Aids (Bundesfachverband Elektronische Hilfsmittel e.V. - BEH). “Some technologies, such as gesture control, have not prevailed, because users did not accept them.”

Even if the range of digital aids is steadily growing and giving potential users more quality of life, there is still a lot to be done when it comes to binding standards. For example, in order to realize accessibility for the deaf in public spaces. “We need to be able to transfer language and acoustical signals – for example announcements at railway stations as well as the sound at public events, in theatres and cinemas – directly and wirelessly to hearing devices,” says Renate Welter, Vice President of the German Association for the Hearing Impaired (Deutscher Schwerhörigenbund e.V.) in Berlin. “Here, we need a comprehensive standard that can be addressed by hearing systems installed publicly and can be used via an aid’s audio signal.”

Ensure accessibility from day one

User-friendly products are not a question of technology, but rather of the chosen approach, says Klaus-Peter Wegge, head of the Siemens Accessibility Center (ACC) at Paderborn University. In his opinion, every product available on the market, from websites and services on the Internet to household appliances, should be able to be used by people with all different types of needs without any help. “This calls for developers to consider possible limitations from day one,” the certified engineer emphasizes. “The technicians will then find the right solutions.”

Together with his team, Wegge, who has been blind since birth, has developed an innovative product for a bank client. “Initially, we asked how a blind person can enter their PIN into bank terminals that are equipped with touch screens. For security reasons, voice output of the PIN was not an option,” he explains. “In this case, we take the familiar telephone keypad and imagine a coin on the five. With one swipe, the visually impaired person pushes the imaginary coin either upwards or downwards, to the left or right, or diagonally and can return to the centre position after double-clicking to confirm. They can reach every number except the zero with one swipe.” The trial run with 600 users yielded best results, and the payment system is already being used widely in Australia.

Besides Klaus-Peter Wegge, one other blind colleague works at the competence centre as well as a colleague who is severely visually impaired, among others. Together, the whole team contributes their expertise to test the usability of devices and technologies for the broadest possible group of users. Some examples are voice output for washing machines, which is designed to helpful for people who are blind as well as those who can see, or accessibility to an app that operates interconnected household devices.

About REHACARE INTERNATIONAL DüsseldorfREHACARE INTERNATIONAL is Europe’s leading trade fair for rehabilitation and medical care. The fair takes place at the exhibition centre in Düsseldorf in every autumn. In six exhibition halls, 960 exhibitors from 40 countries offer a representative overview of aids for an independent life at REHACARE 2018 from September 26 to 29. Informative events in the halls, theme parks and a congress act as an invitation to obtain more information on current topics around rehabilitation, medical care and ageing. The trade fair will be opening its doors from Wednesday to Friday from 10:00 a.m. to 6:00 p.m. and on Saturday from 10:00 a.m. to 5:00 p.m. For further information and to purchase tickets for the trade fair and conference please visit the internet portal www.rehacare.com.